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A bond of brothers: Siblings and prostate cancer

Men whose brothers have the disease guard against increased risk

added 9/3/04

A University of Michigan Health Minute update on important health issues.

Ann Arbor - Michael Legacki feels like he's
a walking target. With five brothers diagnosed with prostate
cancer, Legacki knows his risk of developing the condition
himself is high.

“I'm very anxious about it, but it's a fact of life.
I feel confident that if I stay on top of it, I'll find it
early enough that it won't be too terrible,” says Legacki,
55.

About 230,000 men develop prostate cancer each year and the
average man faces a 1 in 6 chance of being diagnosed. But
men whose brother or father had prostate cancer face a 1 in
2 risk of developing the disease themselves, and often at
a younger age.

“Prostate cancer does have a hereditary or familial
component to it. We don't know exactly the gene, although
we are narrowing in on that gene,” says
David Wood, M.D., professor of urology at the U-M
Medical School.

Ongoing research at the University of Michigan Comprehensive
Cancer Center is looking at men diagnosed with prostate cancer
and their unaffected brothers to help determine what genes
are involved. Legacki and his brother Frank are enrolled in
the trial.

“I was diagnosed with prostate cancer. I'm the oldest
of eight children, and there are six boys,” says Frank
Legacki, 64. “I had two brothers who had prostate cancer
before me, so I was on high alert. Now five of the six brothers
have had prostate cancer, and my brother Mike here is the
only one who's dodged the bullet so far.”

Mike Legacki knows he faces a high risk of developing prostate
cancer, and recent research shows most men in a similar situation
do too. Men participating in a recent study said they felt
they had a 50 percent chance of developing prostate cancer
within their lifetime, and more than half of the 111 men surveyed
said they were at least somewhat concerned about developing
the disease.

In addition, researchers found these men were altering their
lifestyle to prevent prostate cancer, taking multivitamins
or turning to complementary and alternative medicines linked
to prostate health or cancer prevention, such as vitamin C,
vitamin E, selenium and saw palmetto.

But Wood warns that supplements are not a perfect solution
for preventing prostate cancer.

“Complementary and alternative medications in and of
themselves are safe drugs. But they are a drug and it's important
that patients tell their physicians what type of complementary
and alternative medications they're taking,” he says.
“The second concern I have is that men will take these
medications in lieu of standard medical practice, and that's
a major concern. It is a good addition, but it's not a substitution
for standard care.”

Michael Legacki says he's aware of medical studies indicating
a possible benefit to supplements such as lycopene or selenium,
but he is not using complementary medicine.

“I do watch my diet and just try to take care of myself
generally. I have been getting check-ups regularly, including
a PSA test, and so far it's been good,” Legacki says.

Annual PSA,
or prostate specific antigen, tests are recommended for all
men after age 50. Men at higher risk – including men
with a family history of the disease – should begin
screenings earlier.

“The first thing a man who has a brother with prostate
cancer should realize is that he's at a higher risk of developing
prostate cancer,” Wood says. “Those unaffected
men should have a PSA blood test and a digital rectal exam
every year starting at age 45. They should also realize that
if they're going to take complementary alternative medication,
they should tell their doctor what drugs they're taking.”

The Prostate
Cancer Genetics Project at U-M is continuing to recruit
patients who have brothers, fathers or sons with prostate
cancer or who have developed prostate cancer before age 55.
For questions about
prostate cancer research or care at the U-M Comprehensive
Cancer Center , call the Cancer AnswerLine™ at 800-865-1125.

Who's at risk

Age. The risk of prostate cancer increases
after age 50 or after age 40 in African-Americans or in
men with a family history.

Family history. Men with one first-degree
relative with prostate cancer face double the risk and
men with two first-degree relatives are at five times
the risk.

Race. Prostate cancer affects African-Americans
1.5 times more often than white men.

Diet. Some studies suggest a high-fat
diet increases the risk of prostate cancer.

Geography. Prostate cancer rates are
highest in Scandinavian countries and lowest in Asia.

Preventing prostate cancer

Researchers are looking into several possibilities
for preventing prostate cancer:

Diet. Some studies suggest a diet high
in the antioxidant lycopene may help prevent prostate
cancer. Lycopene is most commonly found in tomatoes.